lecture 7b continues Flashcards
what is the MOI for meniscal injuries
closed chain twisting injury , combination valgus/ hyperextension force
what are the 5 factors that are associated with meniscal tear
• History of mechanical catching or locking
• Injury often associated with forceful twist of femur, especially medial
• Joint line tenderness
• Pain with forced knee hyperextension or maximum passive flexion
• Pain or click with McMurray test
4 or more postivie then 81% sure it is meniscus
what is the best to know if meniscus is involved
joint line tenderness
what are teh CPG for meniscus injury
- 25% of all knee injuries
- HS athletes (more common in females)
- older
- higher in ACL sx
what are teh CPG for articular cartilage injury
- may be asymptomatic
- 2/3 in femoral condyle and patella
- higher after partial menisecetomy
what are the clinical findings for articular cartilage
- acute trauma w hematrhosis
- insidious onset aggravated by repetitive impact
- intermittent pain and swelling
- hx of catching or locking
- joint line tenderness
if a pt has a clinical finding or a twisting injury , tearing sensation , delayed effusion , hx of catching or locking , pain w forced hyperextension , pain w max passive knee flexion , joint line tenderness and pain or audible clinic w mcmurrary maneuver what do u think
meniscus
when is full WB for a articular cartilage injury
6-8 weeks
what is most commm form for orestoarethetic disability in the US
knee OA
what is the altmans criteria for knee OA
• Knee pain and:
• Age >50 yrs
• Knee crepitus
• Palpable bony enlargement
• Bony tenderness to palpation
• Morning stiffness <30 minutes
• No palpable warmth
waht is the kel green lawrence scale for
knee OA
grade 0: nothing on xray
grade 4: large oestophyets
what is better for Knee OA ? manual therapy ,exercise and HEP or just HEP alone
MT , exercise and HEP
what can hip mobs do for the knee
short term increase in knee ROM and decrease in pain
what is the knee OA treatment summary
exercise
check the hip
weight control
mobilization and exercise for knee ROM
what is the MOI for patellofemoral pain syndrome
- Trauma
- Overuse
- Patellar tracking
- Muscle imbalance – check hip
what is associated impairments with Patellofemoral Pain Syndrome (PFPS)
- ↓ quad strength
- ↓ flexibility
- ↓ coordination of quads
- Control of femur-tibial rotation, overpronation, patellar positions
what is the biomechanics for Patellofemoral Pain Syndrome (PFPS)
knee angle affects patellar compression forces
how much does WB exaggerate the compression of Patellofemoral Pain Syndrome (PFPS) with walking and running
- Walking: 25-50% BW
- Running: 5-6x BW
Patellofemoral Pain Syndrome (PFPS) is more common in females or males
athletic females
Patellofemoral Pain Syndrome (PFPS) may be influenced by the interaction of the segments and joints of the LE. in particular abnormal motion of the ___ and ___ in the trasnvers and frontal planes may have an effect on patellofemoral joint mechanics. with this in mid , intervention aimed at controlling ___ and ___ motion and ___/___ motion may be warranted and should be considered when treating persons with patellomfemoral joint dysfunction
tibia and femur
hip and pelvic motion and ankle/ foot
according to the CPG for Patellofemoral Pain Syndrome (PFPS) there is a strong possibility that ___ weakness is a ___ of Patellofemoral Pain Syndrome (PFPS) and not a direct causes
hip
results
if a pt comaplins for prolong sitting pain >30 mins adn then standing up and feeling more pain what do u think
Patellofemoral Pain Syndrome (PFPS)
for pts w Patellofemoral Pain Syndrome (PFPS) they may have pain w step down test .. why
femur IR under patella during step down
if a pateint demonstrates excessive hip
adduction, IR, and knee valgus during gait and
with step-down what is weak?
weak hip abductors,
extensors, ERs
